New test to predict whether your anxiety will respond better to therapy or pills

Selena Gomez and Emma Stone have both spoken out about their anxiety. Photos: Instagram @selenagomez, Getty ImagesSource:BodyAndSoul

A new study has found that a simple test could determine whether patients who suffer anxiety will respond better to therapy – formally known as cognitive behaviour therapy, or CBT – or SSRIs, the class of drugs most commonly used to alleviate the symptoms associated with anxiety disorders.

The research lead by the University of Illinois in Chicago, and helmed by Stephanie Gorka, assistant professor of psychiatry in the UIC College of Medicine, found “that higher electrical activity in the brain in response to committing an error – known as error-related negativity or ERN – was associated with greater symptoms of anxiety,” according to a report by News Medical.

A patient’s ERN, according to Gorka’s study, is the key factor that will determine whether CBT or SSRIs will be a more effective treatment for them, and can be determined through an ECG test, which can measure enhanced the neurological responses triggered when all of us – anxiety disorder, or not – make errors.

“To elicit errors, participants wore an EEG cap while they performed a task that required them to quickly and accurately indicate the direction of a centre arrow embedded within a string of arrows on a computer screen. A new screen would appear each time the participant indicated the direction of the centre arrow using a button,” per News Medical, and is an exercise than becomes more difficult with time, “inevitably lead[ing] to mistakes” and thus triggers the appropriate neurological signals associated with error-making.

Therefore, Gorka and her team were able, through this test, to accurately measure the responses of the 60 adults surveyed with mental health prognoses, and 26 without.

Following the completion of this test, participants who suffered anxiety disorders were randomly selected to take an SSRI every day for 12 weeks, while others were put into CBT sessions weekly, over the same period of time.

Once the respective 12 week treatments came to an end, all participants were required to sit the aforementioned computer arrow test again, to determine whether their therapy had been effective in lowering their ERNs, which is a physiological manifestation of anxiety.

“The researchers found that an enhanced ERN at the beginning of treatment was associated with greater reduction in anxiety for participants who received CBT, but not for those who received SSRIs. In fact, participants prescribed SSRIs had even more enhanced ERN at the end of the 12-week treatment period,” per News Medical, which is interesting, given how widely prescribed these drugs are to treat anxiety.

Another thing to consider is that, sometimes, it can take longer than 12 weeks for an SSRI to effectively treat and anxiety disorder, and alleviate the full suite of symptoms associated with it.

Still, according to Gorka, "we found that ERN can help predict which patients will achieve better outcomes with cognitive behavioural therapy, and that information is very useful because that CBT is a time-intensive, less-available resource and because SSRIs can be associated with side effects, it's good to know that a patient will do better on CBT to reduce the exposure to potential side effects."

The ERN tests are also relatively low-cost, and take just half an hour to complete, meaning this small study, published in the journal of Neuropsychopharmacology, could help patients determine which treatment is more appropriate for them, prior to even beginning treatment.

If you or someone you know needs help, call Lifeline on 131 114, Beyondblue on 1300 22 4636 or Kids Helpline on 1800 55 1800. In an emergency, call 000. For a correct treatment plan, book an appointment with your GP.